Immature Oocytes in “Apparent Empty Follicle Syndrome”: A Case Report

Vutyavanich, Teraporn; Piromlertamorn, Waraporn; Ellis, Jason A.

doi:10.1155/2010/367505

Cited by 14 publications

(12 citation statements)

References 17 publications

(30 reference statements)

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“…A borderline form of EFS was also suggested in cases in which very few mature or immature oocytes are recovered from several mature follicles (Işik and Vicdan, 2000;Nikolettos et al, 2004;Duru et al, 2007;Desai et al, 2009;Vutyavanich et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Empty follicle syndrome: successful treatment in a recurrent case and review of the literature

et al. 2012

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Empty follicle syndrome is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. It is a rare condition of obscure etiology. A patient with primary infertility who underwent seven assisted reproductive technique cycles is described. In spite of a satisfactory ovarian response, aspiration yielded no oocytes in four cycles and 1-4 low quality oocytes in three cycles. In the index treatment cycle, ovulation was triggered using GnRH agonist 40 h prior to ovum pickup and hCG was added 6 h after the first trigger. Eighteen oocytes were recovered, of which 16 were mature and were inseminated by ICSI. Two embryos were transferred 48 h after aspiration and nine embryos were cryopreserved. The patient conceived and delivered a healthy boy at 38 weeks of gestation. The literature is reviewed and possible etiologies and treatment options of this enigmatic syndrome are suggested.

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Section: Discussionmentioning

confidence: 99%

Empty follicle syndrome: successful treatment in a recurrent case and review of the literature

et al. 2012

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“…Other investigators have suggested that some follicles may need longer exposure to hCG for cumulus expansion and detachment of oocyte cumulus complexes from the follicular wall [24-26]. Follicular rupture and oocyte maturation are time-dependent processes being needed at different times in different patients.…”

Section: Underlying Mechanismmentioning

confidence: 99%

“…Desai et al [19] recently showed microscopic evidence of genuine EFS with a case of borderline EFS. A borderline form of EFS was also suggested in which very few mature or immature oocytes are recovered from several mature follicles [19,26,32-34]. The genetic basis for EFS provides strong evidence for the existence of genuine EFS in some patients [27-29].…”

Section: Does Genuine Efs Really Exist?mentioning

confidence: 99%

Empty follicle syndrome

Kim

Jee

2012

Clin Exp Reprod Med

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Empty follicle syndrome (EFS) is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. EFS can be classified into 'genuine' and 'false' types according to hCG levels. It is a rare condition of obscure etiology. The existence of genuine EFS has been questioned and is still controversial. The limitation around EFS is that the definition of EFS is obscure. Management of patients with EFS is a challenge to physicians. No single treatment is known to be universally effective. However, patients should be adequately informed regarding the importance of correct hCG administration because improper hCG administration is a common and preventable cause of EFS. EFS is a syndrome that deserves additional study because such investigation could lead to a further understanding of ovarian biology and infertility.

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“…We have previously shown that, in low responders switching before oocyte retrival from IVF to IUI (Matorras et al, 2003), the pregnancy rate (14%) was similar to the general IUI pregnancy rate, and much higher than that observed in the present study. It has been suggested that a variation in the time needed from HCG exposure to maturation of oocyte-cumulus complexes could be the cause of failure to obtain oocytes (Vutyavanich et al, 2010). As in IUI, however, HCG timing is not as strict as in IVF (Osuna et al, 2004), and we think that this is unlikely to be the reason of the null pregnancy rate.…”

Section: P-valuementioning

confidence: 80%

Failure of intrauterine insemination as rescue treatment in low responders with adequate HCG timing with no oocytes retrieved

Matorras

Aparicio

Corcóstegui

et al. 2014

Reproductive BioMedicine Online

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In this retrospective study, the efficiency of carrying out rescue intrauterine insemination (IUI) in low-responder patients undergoing IVF when no oocytes were retrieved after follicular aspiration and when HCG timing was adequate was analysed. A historical control group was used. Over 13 years, women undergoing IVF with failure to obtain oocytes at follicular aspiration underwent rescue IUI if the following criteria were met: adequate HCG timing; one normal tube; motile sperm count after preparation over 3 million/ml; and ultrasound visualization of one to six follicles over 13 mm. The rescue IUI was carried out 1 h after follicular aspiration. Results were compared with those of a standard IUI population (5394 cycles) in the same period. Confidence intervals were calculated using Poisson 97.5% confidence upper tail limits when no event was observed in the study sample. No pregnancies were achieved among the 54 cases who underwent rescue IUI (confidence interval: 0 to 6.8%). This pregnancy rate was lower than that observed in the general IUI population (17.5%) (relative risk, 19.2). After adjusting for age and endometriosis, the relative risk was 11.7. The rescue IUI is an inefficient procedure. Its efficacy is unlikely to exceed 7% pregnancy rate per IUI.

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Immature Oocytes in “Apparent Empty Follicle Syndrome”: A Case Report

Cited by 14 publications

References 17 publications

Empty follicle syndrome: successful treatment in a recurrent case and review of the literature

Empty follicle syndrome: successful treatment in a recurrent case and review of the literature

Empty follicle syndrome

Failure of intrauterine insemination as rescue treatment in low responders with adequate HCG timing with no oocytes retrieved

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